Provider First Line Business Practice Location Address:
1028 OLD CEDAR BLUFF RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37923-2283
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-215-5950
Provider Business Practice Location Address Fax Number:
865-215-5959
Provider Enumeration Date:
11/30/2012